Summary:

The Island is a collection of three stories sharing a similar setting (Italy) and populated by several characters who are outcasts. In the title story, the relationship between residents of an island and its medieval monastery, the Certosa, decays over time. When a talented stonemason is accidentally injured, his damaged senses are replaced by pain and suffering. His struggle and sacrifice, however, ultimately result in redemption for all those who inhabit "The Island."

In the eighteenth century, a 20 year old leper is condemned to live the remainder of his life in a tower fittingly known as the Tower of Fright. Although befriended by a stranger, the occupant of "The Tower" must nevertheless endure solitude, and he does so with the patience and grace of a saint. With the backdrop of a plague, "The Second Coming" is a medieval tale that recounts the torture of a doubting priest, an unknown pilgrim’s participation in a miracle, and the death of a pope.

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While riding on a commuter train, Bill Chalmers suddenly forgets who he is and where he is headed. His amnesia is accompanied first by a numbness of his hands and then later his legs. Eventually he is confined to a wheelchair and dependent on his family and a home nurse to care for him. Despite extensive testing and consultations with a variety of doctors, no one can make a definitive diagnosis of his illness.

Chalmers is subjected to many empirical treatments including antidepressants, steroids, plasmaphoresis, and psychotherapy, but his health continues to deteriorate and he loses his job. His wife and son become victims of his predicament. By the end of the story, Chalmers gains insight into his life and discovers that only his dignity still remains in his control.

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An aging plastic surgeon afflicted with diabetes examines his life and is forced to confront death and the failures of his past. Dr. Moses Galen is a 69 year old California physician with a penchant for sex, Jaguars, and boxing but a fear of making commitments and experiencing a slow death. He spends a weekend with his girlfriend Linda, a trauma surgeon in her forties. After they have sex, he experiences chest pain that he mistakenly attributes to heartburn. Dr. Galen had coronary artery bypass surgery only three years ago and figures it should last at least ten.

He wakes up early in the morning to work out on his punching bag. His chest pain returns and is now accompanied by ventricular fibrillation. He realizes he is having a myocardial infarction and will die. Despite the pain and his fear, Dr. Galen continues to throw punches. He only hopes he can remain quiet enough not to awaken Linda. If she realizes what is happening, she might try to save his life.

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Leprosy looms large in this story about transformation and loss set in post World War II Japan. A nineteen-year-old pearl diver notices a numb red spot on her forearm. Later on, another blemish appears on her lower back. These two lesions are manifestations of a mild case of leprosy. Her infection will be arrested by medication and never get any worse. The girl is forcibly transported to the Nagashima Leprosarium, an island where she will spend the rest of her life except for a few brief excursions and one extended "escape" at the age of sixty-four.

Despite the introduction of new and effective drugs--Promin (sulphone) and dapsone--authorities still fear allowing the leprous patients to return to society. Inhabitants of the sanatorium are admonished on arrival that their past is erased. Each individual must begin a new life and select a new name. The protagonist chooses the moniker Miss Fuji. She is a kind and sensitive young woman who eventually functions as a nurse and caregiver for the other patients incarcerated in the sanatorium. As a punishment, Miss Fuji is required to attend abortions and dispose of the dead fetuses.

As the decades pass, conditions on the island improve. The number of residents with leprosy still living there dwindles from about two thousand people to six hundred. Even a bridge connecting Nagashima to the mainland is constructed. It no longer matters. Emotional and psychological barriers remain. When Miss Fuji has an opportunity to create a new life for herself away from the sanatorium, she still returns to the place and the people that have been her home and family for so many years.

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John Ames narrates this story in the form of a lengthy letter to his young son. Ames is a 76-year-old minister suffering from angina pectoris and heart failure. He has spent almost all of his life in Gilead, a small town in Iowa. His first wife died during childbirth along with a baby girl. Ames remarried a younger woman who is now 41. They have a son almost 7 years old.

Because Ames believes his death is close at hand, he pens a missive to the boy. Its purpose is to teach his son about all the important things in life Ames may not be around to share with him. During the course of composing the letter, Ames reflects upon his own existence. He recalls the experiences of his father and grandfather who were also ministers.

Reverend Ames likes to think, read, and pray. Born in 1880, he has lived through three wars, the Great Depression, a pandemic of influenza, and droughts. His hope is that his young son will grow into a brave and useful man.

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Five women find fellowship and comfort in the swimming pool at a community center managed by Ursuline nuns. Each woman suffers from a chronic disease--lupus, multiple sclerosis, Crohn's disease, and rheumatoid arthritis. One is also being treated for ovarian cancer. The diverse group includes a pregnant woman, an elderly nun, and a retired nurse who currently peddles Avon products. On Tuesdays and Thursdays, they participate in aquatic therapy. The one-hour sessions temporarily soothe the body and boost morale. It is a welcome reprieve from the burden of disease and the complications of life.

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When oral antibiotics are no longer effective, the narrator grudgingly consents to begin a six-week course of intravenous antibiotic therapy with Rocephin (a powerful, broad-spectrum antibiotic). She has an infection caused by spirochetes. The illness has been festering for as long as ten years but has only recently been diagnosed. It causes joint pain and stiffness. Her daughter has already been successfully treated for the same infection.

Every morning in her kitchen, the narrator performs the same ritual. She cautiously infuses the antibiotic and imagines that the golden fluid is extinguishing the corkscrew-shaped microbes. At first she experiences a drug reaction, but the event only convinces her that the treatment is actually working.

She senses that her husband and her friend are repulsed by the treatment (especially the syringes and IV apparatus). A visiting nurse, Ginger, comes to the house to perform minor maintenance on the intravenous line. She upsets the narrator with grim information about the infection and an account of a patient suffering from the same disease who is currently in awful condition. Dr. Kennicott, the narrator's physician, has not been so forthcoming about the course of the illness or pessimistic about the prognosis. The narrator chastises Ginger. Both women are now distressed. The narrator's immediate goal is to control her emotions and avoid crying.

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Celia has her hands full. The maxillofacial prosthetist is overwhelmed by the demands of caring for her ill husband at home. Her job - crafting replacement parts for people whose faces are damaged - is truly art but involves interacting with distraught patients and angry families. Her mother constantly telephones to offer unsolicited advice. Celia's husband, Simon, has multiple sclerosis. He has been treated in the emergency department many times and recently has been on a ventilator. Celia realizes that she unintentionally hurts Simon just by caring for him. She has never developed the knack of painlessly administering his injections. When she attaches the feeding pump to his G-tube (a feeding tube permanently set in the stomach), she induces pain by yanking too hard. Her mother, Bess, and best friend, Leslie, try to convince Celia that Simon would be better off in a nursing home, and her life would be less stressful. Although she has a lover, Celia cannot face losing her husband.

One of Celia's clients is an 8-year-old boy, Junius Jones. Most of his left ear was torn off after he was struck by a van. Celia constructs a silicone ear for the boy. She is deeply troubled when the boy's mother cancels his prosthetic fitting twice. Celia's mother is reading a biography of Henry David Thoreau and shares an inspiring quote by Thoreau with her daughter: "Live the life you've imagined" [p 120]. Perhaps Celia is incapable of imagining a hopeful future. Maybe Junius Jones and his mother are unable too.

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Robert Murphy was a professor of anthropology at Columbia University when he became progressively paralyzed by an inoperable spinal cord tumor. His book is a personal journey through profound physical disability, an exploration of the self, and a study of the social construction of disability ["Disability is defined by society and given meaning by culture; it is a social malady" (4)]. As he writes The Body Silent he is virtually quadriplegic, hitting the keys of his computer with the eraser end of a pencil held in place by a 'universal cuff' wrapped around his palm. He is still traveling to Columbia to teach his classes.

Murphy applies the metaphor of an anthropological field trip to his experience: "This book was conceived in the realization that my long illness with a disease of the spinal cord has been a kind of extended anthropological field trip, for through it I have sojourned in a social world no less strange to me at first than those of the Amazon forests. And since it is the duty of all anthropologists to report on their travels . . . this is my accounting" (ix). Drawing not only on his own experience but also on research for which he received funding, Murphy instructs his audience in the metaphysics of his situation, and in the social as well as physical challenges of disability.

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Professor of performance studies at New York University, Peggy Phelan narrates the story of a vision disorder that began when she was 23 years old, caused by "open-angle glaucoma," a difficult-to-treat condition in which the vessels draining ocular fluid periodically constrict. The episodes are excruciatingly painful and disorienting: "I feel a staggering push behind my right eye. The right upper half of my face is on fire: I am certain that my eye has fallen out of its socket . . . " (508).

Phelan resists patienthood, beginning with her first visit to the doctor, in which she underplays what has happened to her. Rejecting surgery, coping with side effects of the drugs she must take, and concerned about her ability to continue as a visual arts scholar, she muddles through for several years. Then she experiences a frightening, vividly described episode of temporary blindness, which is followed by a migraine headache. Six months later she agrees to have surgery.

During the surgery, under local anesthesia, "my eye, which is frozen, can still see things as they pass over it . . . colors I have never seen before . . . I am seeing the roof of my own eye from the interior side. It is utterly breath stopping. I cannot speak" (521-522). Enabled to see her eye from a perspective that was not available to the physician, and grateful for this "visionary experience," Phelan finally accepts her situation. She is not cured, although her condition improves. "My story is finally the same as those of all the other patients . . . The only difference between me and them comes from the words I’ve suffered to find and the words I’ve suffered to flee" (525).

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